富白细胞血小板纤维蛋白作为抗生素缓释生物装置治疗中度牙周炎的评估：一项随机对照临床试验。
Evaluation of leukocyte-platelet rich fibrin as an antibiotic slow-release biological device in the treatment of moderate periodontitis: a randomized controlled clinical trial.
作者信息
Omar Yasmeen K, Rashidy Mohy A El, Ahmed Ghada B, Aboulela Aliaa G
机构信息
Department of Oral Medicine, Periodontology, Oral Diagnosis and Oral Radiology, Faculty of Dentistry, Alexandria University, Champollion St, Azarita, 21527, Alexandria, Egypt.
Department of Microbiology, Medical Research Institute, Alexandria University, Azarita, Egypt.
出版信息
BMC Oral Health. 2024 Dec 21;24(1):1530. doi: 10.1186/s12903-024-05254-x.
BACKGROUND
Periodontitis is a chronic inflammatory disease caused by the accumulation of biofilm. Antimicrobials have been used as adjuncts to non-surgical periodontal therapy. However, systemic antibiotics often require large dosages to achieve suitable concentrations at the disease site. Leukocyte platelet-rich fibrin (L-PRF) is a promising bio-material, with antimicrobial, anti-inflammatory, and wound-healing enhancement effects. This study aimed to evaluate the efficacy of L-PRF as a locally sustained released device for metronidazole antimicrobial.
METHODS
Twenty-four patients with eighty periodontal pockets had moderate periodontitis with attachment loss of 3-4 mm, and probing depth ≤ 5, which was equally divided into two groups: Group (I) underwent scaling and root planing with intra-pocket application of L-PRF loaded with Metronidazole, while Group (II) was treated by scaling and root planing with intra-pocket application of L-PRF alone. Microbiological measurements were taken at baseline and after one month to analyze the relative count of Porphyromonas gingivalis (P. gingivalis) using real time PCR. Clinical parameters were measured at baseline and after 1, 3, and 6 months. These parameters included probing depth (PD), clinical attachment loss (CAL), plaque index (PI), modified gingival index (MGI), and bleeding index (BI).
RESULTS
Microbiological and clinical findings revealed that both treatment methods resulted in a reduction in P. gingivalis counts, in addition to improvements in the clinical parameters: PD reduction, CAL gain, PI reduction, BI decrease and MGI reduction compared to baseline. However, L-PRF-metronidazole group showed superior results in the studied parameters over the study period. Nonetheless, there was no statistically significant improvement. (p < .001).
CONCLUSION
The intra-pocket application of both L-PRF loaded with Metronidazole and L-PRF alone contributed to the successful treatment of moderate periodontitis.
TRIAL REGISTRATION
NCT06153706 ( http://www.clinical-trials.gov/ ); 1/12/2023, retrospective registration.
背景
牙周炎是一种由生物膜堆积引起的慢性炎症性疾病。抗菌药物已被用作非手术牙周治疗的辅助手段。然而，全身用抗生素通常需要大剂量才能在疾病部位达到合适的浓度。富白细胞血小板纤维蛋白（L-PRF）是一种有前景的生物材料，具有抗菌、抗炎和促进伤口愈合的作用。本研究旨在评估L-PRF作为甲硝唑抗菌局部缓释装置的疗效。
方法
24例患者共80个牙周袋，患有中度牙周炎，附着丧失3-4mm，探诊深度≤5mm，将其平均分为两组：第一组接受龈下刮治和根面平整，并在牙周袋内应用负载甲硝唑的L-PRF，而第二组仅接受龈下刮治和根面平整，并在牙周袋内应用L-PRF。在基线和1个月后进行微生物学检测，使用实时PCR分析牙龈卟啉单胞菌（牙龈卟啉单胞菌）的相对计数。在基线以及1、3和6个月后测量临床参数。这些参数包括探诊深度（PD）、临床附着丧失（CAL）、菌斑指数（PI）、改良牙龈指数（MGI）和出血指数（BI）。
结果
微生物学和临床研究结果表明，两种治疗方法均导致牙龈卟啉单胞菌数量减少，临床参数也有所改善：与基线相比，PD降低、CAL增加、PI降低、BI降低和MGI降低。然而，在研究期间，L-PRF-甲硝唑组在研究参数方面显示出更好的结果。尽管如此，差异无统计学意义（p＜0.001）。
结论
牙周袋内应用负载甲硝唑的L-PRF和单独应用L-PRF均有助于成功治疗中度牙周炎。
试验注册
NCT06153706（http://www.clinical-trials.gov/）；2023年12月1日，回顾性注册。
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